A paradigm shift in imaging for renal colic - Is it time to say good bye to an old trusted friend?

OBJECTIVES

To study the changing pattern in the use of intravenous urogram (IVU) and non-contrast enhanced CT (CTKUB) for evaluation of flank pain at a single centre.

METHODS

All patients who underwent either an IVU or CTKUB at a single, tertiary care center from January 2002 to December 2007 were retrospectively identified from the radiology database. Study samples were-divided into two groups: Pediatric (14 years or less) and Adult (greater than 14 years). For each group, overall trends as well as trends across referral setting and gender were explored by plotting line graphs using SPSS version 15.

RESULTS

During the study period a total of 11245 uro-radiological examinations were performed using either IVU (43.7%, n=4915) or CTKUB (56.3%, n=6330). A remarkable majority of procedures (95.5%, n=10741) was performed in adult patients. Overall, the respective proportions of IVU and CTKUB were 87.9% (n=43) and 12.1% (n=61) in the pediatric group whereas 41.6% (n=4472) and 58.4% (n=6269) in adults. Majority in both groups were ambulatory patients (Pediatrics 83.7%, Adults 76.7%). During 2002-20007, the yearly proportion of CTKUB increased from 27% to 80% in adults and from 3% to 27% in children.

CONCLUSIONS

There is major shift in the choice of imaging in adults from IVU to CTKUB during years 2002-2007. In pediatric patients, IVU referrals still comprise the greater proportion of uro-radiological exams.